NUR 448 Exam 1 Questions with Correct Answers Latest Update 2025-2026
1. M, age 26 months, is very negativistic. He refuses to have anything to do with toilet training and
shouts "No!" all the time. His mother asks what might be the matter with M. The nurse can assess M as
dealing with the psychosocial crisis of
a. autonomy versus shame and doubt
b. initiative versus guilt
c. industry versus inferiority
d. trust versus mistrust - Answers A
2. Steve is M's 4-year-old brother. He sometimes grabs toys away from M, saying "I want that!" Using
Freudian theory the nurse can interpret this behavior as a product of impulses originating in the
a. ego
b. id
c. superego
d. preconscious - Answers B
3. A client mentions, "I'm going to be engaging in cognitive therapy. What can I expect from the
sessions?" Which remark would the nurse, framing a reply, find inappropriate to include?
a. "The therapist will be active and questioning."
b. "You may be given homework assignments."
c. "The therapist will help you look at ideas and beliefs you have about yourself."
d. "The goal is to increase your subjectivity about the thoughts that govern your behavior." - Answers D
4. Two psychotic clients on the inpatient unit fight whenever they are together in the same room. During
a team meeting, one nurse suggests the safety of the two clients is of paramount importance and that
their treatment plans should call for both to be placed in seclusion to keep them from injuring each
other. What is the significance of this suggestion?
a. It violates the civil rights of the two clients.
b. It reinforces the autonomy of the two clients.
c. It reveals that the nurse values the principle of justice.
d. It represents the intentional tort of battery. - Answers A
, 5. In a treatment team planning meeting a nurse states her concern about whether the staff is behaving
ethically in using restraint to prevent one client from engaging in self-mutilative behavior when the care
plan for another self-mutilating client calls for one-on-one supervision. The ethical principle that should
govern the situation is
a. beneficence
b. autonomy
c. fidelity
d. justice - Answers D
6. A client tells the nurse, "When I saw my therapist yesterday, he made sexual advances. He stroked my
breast and suggested that he will give me a pass to leave the hospital if I will meet him at his
apartment." What action should the nurse take?
a. None. Psychiatric clients are not reliable.
b. Report the client's statements to the unit nurse manager.
c. Discuss the statements with the medical director.
d. Call the state medical board. - Answers B
7. J became aggressive, struck another client, and required seclusion. Which of the following would be
an appropriate way to document this event?
a. "Client apparently doesn't like client X as evidenced by his striking client X when client attempted to
leave day room to go to bathroom. Seclusion necessary at 2:15 pm. Plan: Maintain seclusion for 8 hours
and keep this client and client X away from each other for 24 hours."
b. "Seclusion ordered by Dr. at 2:15 pm when voices told the client to hit another client."
c. "Client pacing, shouting at people not present in the environment. Chlorpromazine 50 mg p.o. at 1 pm
with no effect by 2 pm. At 2:15 pm client shouted that he would punch the first person who got near
him, then struck client X on the jaw with his fist as client X walked out of day room to go to bathroom.
Client physically restrained by staff and placed in seclusion by order of Dr."
d. "Seclusion begun at 2 - Answers C
8. Which nursing intervention could be considered to violate the rights of the psychiatric client?
a. The nurse imposes suicide precautions before the client has been interviewed by the physician.
b. The nurse opens and reads mail the client has left at the nurse's station to be mailed.
c. The nurse places the client's expensive watch in the hospital safe.
1. M, age 26 months, is very negativistic. He refuses to have anything to do with toilet training and
shouts "No!" all the time. His mother asks what might be the matter with M. The nurse can assess M as
dealing with the psychosocial crisis of
a. autonomy versus shame and doubt
b. initiative versus guilt
c. industry versus inferiority
d. trust versus mistrust - Answers A
2. Steve is M's 4-year-old brother. He sometimes grabs toys away from M, saying "I want that!" Using
Freudian theory the nurse can interpret this behavior as a product of impulses originating in the
a. ego
b. id
c. superego
d. preconscious - Answers B
3. A client mentions, "I'm going to be engaging in cognitive therapy. What can I expect from the
sessions?" Which remark would the nurse, framing a reply, find inappropriate to include?
a. "The therapist will be active and questioning."
b. "You may be given homework assignments."
c. "The therapist will help you look at ideas and beliefs you have about yourself."
d. "The goal is to increase your subjectivity about the thoughts that govern your behavior." - Answers D
4. Two psychotic clients on the inpatient unit fight whenever they are together in the same room. During
a team meeting, one nurse suggests the safety of the two clients is of paramount importance and that
their treatment plans should call for both to be placed in seclusion to keep them from injuring each
other. What is the significance of this suggestion?
a. It violates the civil rights of the two clients.
b. It reinforces the autonomy of the two clients.
c. It reveals that the nurse values the principle of justice.
d. It represents the intentional tort of battery. - Answers A
, 5. In a treatment team planning meeting a nurse states her concern about whether the staff is behaving
ethically in using restraint to prevent one client from engaging in self-mutilative behavior when the care
plan for another self-mutilating client calls for one-on-one supervision. The ethical principle that should
govern the situation is
a. beneficence
b. autonomy
c. fidelity
d. justice - Answers D
6. A client tells the nurse, "When I saw my therapist yesterday, he made sexual advances. He stroked my
breast and suggested that he will give me a pass to leave the hospital if I will meet him at his
apartment." What action should the nurse take?
a. None. Psychiatric clients are not reliable.
b. Report the client's statements to the unit nurse manager.
c. Discuss the statements with the medical director.
d. Call the state medical board. - Answers B
7. J became aggressive, struck another client, and required seclusion. Which of the following would be
an appropriate way to document this event?
a. "Client apparently doesn't like client X as evidenced by his striking client X when client attempted to
leave day room to go to bathroom. Seclusion necessary at 2:15 pm. Plan: Maintain seclusion for 8 hours
and keep this client and client X away from each other for 24 hours."
b. "Seclusion ordered by Dr. at 2:15 pm when voices told the client to hit another client."
c. "Client pacing, shouting at people not present in the environment. Chlorpromazine 50 mg p.o. at 1 pm
with no effect by 2 pm. At 2:15 pm client shouted that he would punch the first person who got near
him, then struck client X on the jaw with his fist as client X walked out of day room to go to bathroom.
Client physically restrained by staff and placed in seclusion by order of Dr."
d. "Seclusion begun at 2 - Answers C
8. Which nursing intervention could be considered to violate the rights of the psychiatric client?
a. The nurse imposes suicide precautions before the client has been interviewed by the physician.
b. The nurse opens and reads mail the client has left at the nurse's station to be mailed.
c. The nurse places the client's expensive watch in the hospital safe.
